Cushing’s disease is a rare condition caused by excess cortisol in the body, leading to symptoms such as weight gain, high blood pressure, and decreased bone mass. It is diagnosed through urine testing and imaging, and treated with surgery and radiation.
Cushing’s disease is a rare condition, affecting about 10 in a million people, caused by excess cortisol in the body. Cortisol is more commonly known as the stress hormone, as it is produced during the body’s natural “fight or flight” reflex. It also reduces inflammation, aids the liver in the removal of toxins, and helps the body use salt properly. Too much cortisol in the body, however, can be dangerous to a person’s health, causing problems such as reduced immunity and decreased bone mass. Left untreated, Cushing’s disease can lead to heart disease and possibly death.
Cushing’s syndrome refers to increased cortisol levels for one of two reasons. The first is a side effect of taking glucocorticoid medications, such as asthma medications or other medications that contain steroids. The second cause is the overproduction of cortisol in the adrenal glands. This second type of Cushing’s is called Cushing’s disease. Although it is also present in dogs and horses, it is more common in humans.
Overproduction of cortisol in the adrenal glands is the result of a small, noncancerous tumor, called an adenoma, in the pituitary glands, which are located near the bottom of the brain. The pituitary glands control adrenocorticotropic hormone (ACTH). ACTH is then transported to the adrenal glands, which are located near the kidneys. Based on the amount of ACTH released, the adrenal glands produce the cortisol that the body needs.
The most common symptom of Cushing’s disease is weight gain, predominantly in the trunk and around the face. Excess deposits of fat around the neck, collarbone and face are often observed. Increased sweating, insomnia, high blood pressure, and dry, thin skin are also common symptoms. Women may see increased hair growth and may suffer from irregular periods. High blood pressure, diabetes, and longer healing times can also be symptoms of Cushing’s disease.
Cushing’s disease is diagnosed by comparing the levels of cortisol in a person’s urine over a 24-hour period. In addition to urine testing, magnetic resonance imaging (MRI) and computed tomography (CT) can also be used. Once Cushing’s disease has been confirmed, surgery will be scheduled. During surgery, tumors in the pituitary gland will be removed. Radiation treatments may be used for a short time after surgery, to ensure that the tumor does not come back. Steroid replacement drugs will also be used until the pituitary glands start working normally again.
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